MEDICARE: DR. SARAH E MCBANE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	16843	NC
2	1835P1200X	Pharmacotherapy Pharmacist	63712	CA
3	1835P2201X	Ambulatory Care Pharmacist	63712	CA
4	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	63712	CA

General Provider Information

NPI Number	:	1376655852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH E MCBANE PHARMD

Provider Business Mailing Address
First Line	:	10698 PASSERINE WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-4200
Country	:	US
Telephone Number	:	858-822-3391
Fax Number	:

Provider Business Practice Location Address
First Line	:	MC 0719
Second Line	:	9500 GILMAN DRIVE
City	:	LA JOLLA
State	:	CA
Zip	:	92093-0001
Country	:	US
Telephone Number	:	858-822-3391
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/03/2016

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